{"npi":"1154901973","type":"NPI-2","status":"active","name":{"display":"Faithwell Counseling And Services, Llc.","other":[],"organization_name":"FAITHWELL COUNSELING AND SERVICES, LLC.","authorised_official":"Mireille Gaines"},"specialty":{"primary_taxonomy":"101YP2500X","primary_taxonomy_description":"Professional Counselor","slug":"professional-counselor","schema_org_specialty":null,"all":[{"code":"101YP2500X","description":"Professional Counselor","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"1204 MAIN ST STE 512","city":"BRANFORD","state":"CT","postal_code":"064053787","country_code":"US","phone":"6783144695","fax":"2034817634"},{"purpose":"MAILING","street_1":"1204 MAIN ST STE 512","city":"BRANFORD","state":"CT","postal_code":"064053787","country_code":"US","phone":"6783144695","fax":"2034817634"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"1154901973","state":"CT","issuer":null},{"type_code":"05","label":"Medicaid","value":"1861040065","state":"CT","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2021-04-14","last_updated":"2021-06-08","_meta":{"source":"NPPES","snapshot_date":"2021-06-08","doc_url":"https://findmynpi.com/api"}}